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ESA Hyporesponsiveness Is Associated with Adverse Events in Maintenance Hemodialysis (MHD) Patients, But Not with Iron Storage

Author

Listed:
  • Takahiro Kuragano
  • Kenichiro Kitamura
  • Osamu Matsumura
  • Akihiko Matsuda
  • Taiga Hara
  • Hideyasu Kiyomoto
  • Toshiaki Murata
  • Shouichi Fujimoto
  • Hiroki Hase
  • Nobuhiko Joki
  • Atushi Fukatsu
  • Toru Inoue
  • Yukihiro Itakura
  • Takeshi Nakanishi

Abstract

Objective: It has been reported that hyporesponsiveness to erythropoiesis-stimulating agent (ESA) is associated with adverse events in patients on maintenance hemodialysis (MHD). However, it has not been determined whether higher iron storage is associated with an improved response, including better survival, to ESA. Design and Method: We measured serum ferritin, hemoglobin (Hb), and transferrin saturation (TSAT) levels every three months for two years in 1,095 MHD patients. The weekly dose of ESA to Hb ratio was also calculated as an index of ESA responsiveness (ERI). Results: A significant correlation (p 280); however, serum ferritin and TSAT levels did not predict a higher ERI. In the time-dependent Cox hazard model, the risk for a composite event in the patients with a high ERI (≥280) and a high ferritin level (≥100 ng/mL) was significantly greater (hazard ratio [HR], 2.09, P = 0.033) than that for patients with a high ERI and a low ferritin (

Suggested Citation

  • Takahiro Kuragano & Kenichiro Kitamura & Osamu Matsumura & Akihiko Matsuda & Taiga Hara & Hideyasu Kiyomoto & Toshiaki Murata & Shouichi Fujimoto & Hiroki Hase & Nobuhiko Joki & Atushi Fukatsu & Toru , 2016. "ESA Hyporesponsiveness Is Associated with Adverse Events in Maintenance Hemodialysis (MHD) Patients, But Not with Iron Storage," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-17, March.
    • Handle: RePEc:plo:pone00:0147328
    DOI: 10.1371/journal.pone.0147328
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